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NPI Code Detail

MEDICARE: OUR LADY OF MERCY MEDICAL CENTER OUTPATIENT PSYCHIATRIC PROGRAMS

MEDICARE: OUR LADY OF MERCY MEDICAL CENTER OUTPATIENT PSYCHIATRIC PROGRAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/CenterF401056NY

General Provider Information

NPI Number : 1821271214
Entity Type Code : Organization
Provider Name (Legal Business Name) : OUR LADY OF MERCY MEDICAL CENTER OUTPATIENT PSYCHIATRIC PROGRAMS
Provider Business Mailing Address
First Line : 4401 BRONX BLVD
Second Line :
City : BRONX
State : NY
Zip : 10470-1407
Country : US
Telephone Number : 646-361-7158
Fax Number :
Provider Business Practice Location Address
First Line : 4401 BRONX BLVD
Second Line :
City : BRONX
State : NY
Zip : 10470-1407
Country : US
Telephone Number : 646-361-7158
Fax Number :
Authorized Official
Title or Position : NURSE PRACTITIONER IN PSYCHIATRY
Name : MS. CRISANTA AZORES ROCKWELL
Credential : RN, NPP
Telephone Number : 646-361-7158
Provider Enumeration Date : 12/09/2007
Last Update Date : 12/09/2007

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Directions to “OUR LADY OF MERCY MEDICAL CENTER OUTPATIENT PSYCHIATRIC PROGRAMS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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